HomeMy WebLinkAboutPermit Sewer Connection Record 1998-10-13
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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LOCATION OF PROPOSED WORK'
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ASSESSORS MAP:
LOT'
OWNER'
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ADORE'"''
CITY,
DESCRIBE WORK'
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
K, J.
)V)c;, 11..1
BLOCK:
STATF' On.
V/A/() V
DEMOLISH
OTHER
..
JOB NUMBER
q YOb c.;}
225 Fifth Street
Sprlnglleld, Oregon 97477
TAX LOT'
SUBDIVISION'
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PHONF'
\..'Yi
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97'0 V
ZIP:
ADDRESS
G",);-71!"'<-7~"'"
CONST,
CONTRACTOR'
51/2.- (VI?,,,) V
EXPIRES ','" PHONE
GENERAl.
PLUMBING:
MECHANICAl'
ELECTRI(" I .
- OFFICE uSE.uTENTION'Oregon law req ,
foil I' U1res you to
LAND USE' , ,,?W ru es adoPte~l'l~ ~ji,W:n....!.!lliitv
QUADOO'f'lCC: ' - ~.".lh~dhulI Genter, Those rules an;; set forth
. OF ~HRl3~EflII'r.::- :II.\I:~ ::XrIR~THE W{)~I\ UNITS, ;;:'~~R'riCJ.c;~.nD1-0010~~~fi/Fl~!J"WI'
occy JWm~I'!E[, 'J..~~c TUIt:' c.ERMIT IS~STR. TYPE' '.. OU may obtain.c'&pi~~t-.l!~e.Il.'I"~ "-',
-cat, ""lj me center, (Note: the tele~one .
. OF ~1lllffi~I/"l:n r"lJ:lICl ARANnn.NED FOfflEAT SOURCE: u_.. nU!)1berfor tl1e Orege/jmIhUA~i I .T;.
Ce t ' 'Y nlUl Iv,"
WATERr8E:l>.T'EA"~Y PERIOD RANGE, _ n erls 1'8~?WbTAGE:
To request an Inspection, you must call 726-3769, This Is a 24 hour recording. All Inspections requested belore 7:00 a.m, will be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
o Site Inspectfon - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting,
o Foundation - After forms are
erected'but prior to concrete
placement.
~rground Plumbing - Prior
~i;;;;:rrjlng trench.
o Underfloor Plumblng/Mechanlcel
-. Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor InsulaUon - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to mllng
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - Atter fireplace approval
and Installation of unit.
o Curbeut & Approach - Atter
forms are erected but prior to
placement of concrete.
o Sldewallt & Driveway - After
excavation Is compiete. forms
and sub.base material In place.
o Fence - ,",Vhen cOi"r'lpleted.
o Slreet Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing w9rlt is complet.e.
o Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final BUilding - When all
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water .'3nd sewer. .
o Electrical Connection - When
blocking, set-up, and plumbIng
inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
.
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Panhandle 'r
Topography
Total height
Cul.de.sac
BUILDING PERMIT 'II
.~ 't
ITEM
sa, FT.
X $/50. FT. ~
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential B~th(s) N'
Sanitary S~wer FT.
Water FT.
Storm Sewer FT. Z-SOV
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile' Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
I PL.
IN
Is
w
----
E
VALUE
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'FEE
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IS THE PROPOSED WORK tN THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
, I ' ,
HSE GAR Ace
APPROVED:
BUILDING VALtJE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City of Springfield, Including the
Development Code, regulating the constructlon and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Cherge 15 due on all undeveloped
properties within tile City limits which are being Improved,
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby cerllfy that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701,055 will be used on thla
project.
I further agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card 15 located at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
Signature ,~ ~
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Date
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or
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VALIDATION:
RECEIPT NUMBER
DATE PAIr'
AMOUNT RECEIVED
RECEIVED BY
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